Addressing Diagnostic Challenges in Acquired Apraxia of Speech: A Preliminary Study to Inform Curriculum Development

Area of Science:

• Neurolinguistics
• Speech-Language Pathology
• Clinical Diagnostics

Background:

• Acquired apraxia of speech (AOS) often co-occurs with aphasia and dysarthria.
• This co-occurrence complicates accurate diagnosis by speech-language pathologists (SLPs).
• There is a need to improve diagnostic accuracy and clinician confidence in identifying AOS.

Purpose of the Study:

• To explore the diagnostic processes and decision-making of SLPs evaluating individuals with potential AOS.
• To identify challenges in diagnosing AOS when co-occurring with aphasia and/or dysarthria.
• To inform the development of training curricula for improved diagnostic accuracy.

Main Methods:

• Eight licensed SLPs evaluated recorded speech samples from individuals with aphasia and potential motor speech impairments.
• Stimuli included standardized speech and language assessments.
• SLPs completed the Apraxia of Speech Rating Scale (ASRS) and diagnostic process questionnaires.

Main Results:

• Most SLPs reported low confidence in diagnosing AOS.
• Prosodic elements and groping were frequently identified as salient features.
• Interrater reliability for AOS diagnosis was poor, with low agreement on the ASRS.

Conclusions:

• Clinician judgments for AOS diagnosis show significant variability.
• Reliably diagnosing AOS with co-occurring conditions remains a challenge.
• Specialized training programs are needed to enhance diagnostic accuracy and clinician confidence.